From Head to Toe, Skin Cancer Can Appear in Unexpected Places

The places where I didn’t know you could get skin cancer – inside your outer ear and under your toenail – are places where it actually can happen.

I know about one (under your toenail) because I bumped into a story about it. I know about the other (in your outer ear) because it happened to me.

First, the toe:

I went for a hike in the woods. It was good to get out in nature, with a friend and our dogs. My toenails needed a trim. I was in a rush. I put on hiking boots I don’t usually wear. My toes banged into the top of my shoe. Shortly after I came home, I saw that my toe had turned black. It was partially dislodged and painful.

I looked up what to do about black toenails and read in Runner’s World that a toenail that turns black, in the absence of an injury, could signal melanoma. That was news to me.

A melanoma!?

The National Center for Biotechnology Information explains it this way: "Subungual melanoma is a distinct subtype of cutaneous malignant melanoma arising from structures within the nail apparatus. The word subungual is derived from the Latin 'sub' meaning beneath and 'unguis' meaning nail or claw. Subungual melanomas are rare and account for 0.7% to 3.5% of all malignant melanomas worldwide."¹

Since subungual melanoma isn’t caused by sun, it can be harder to prevent than other forms of cancer. But keeping your feet clean and being on the lookout for changes can help.

Self diagnose or see a professional?

I am quick to diagnose myself with a disease that I read about. But in this instance, I know the cause of injury… and melanoma is a suspect when there is NO injury.

When it hurt more in the beginning, I considered seeing a doctor to make sure it isn’t infected. As a person with a compromised immune system due to the Prednisone I’ve been taking since my stem cell transplant, I have to be careful.

Also, since the nail is partially detached, another reason for seeing a doctor is to get the dead nail trimmed or removed so that a new one can grow in. This does not appeal to me. The nail doesn’t hurt anymore, so I am wavering about the doctor visit. (If you suspect a melanoma, then, of course, you should go.)

Second, the ear:

As for the skin cancer in my ear, I rubbed my finger inside my ear and it came out bloody. The area kind of healed. I rubbed it again, and again blood came out.

My dermatologist said it looked like basal cell carcinoma. Biopsy results proved her to be correct. She sent me for Mohs surgery. It was one of the worst healing processes of all that I have been through.

Nothing smaller than your elbow, EXCEPT sunscreen

You grow up hearing, “Never put anything smaller than your elbow in your ear.”

The reason for this advice is that if you insert cotton swabs or anything else into your ear to remove wax, you are at risk for perforating your eardrum.

It probably doesn’t apply to putting in a little dab of sunscreen.

In the back of my mind, was I thinking it was an area to avoid?

Probably not. It just didn’t occur to me. Now, however, I try to remember to gently pat a dab of sunscreen into and around each ear.